Value-Based Licensing Application Form
Apply for a license by providing details about your intended use and the value it brings.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Organization Name (if applicable)
Position or Title
*
Type of License Requested
*
Please Select
Single Use
Annual
Perpetual
Other
Describe the Intended Use of the Licensed Resource or Service
*
Explain the Value or Impact Your Use Will Provide
*
Please select the primary area(s) of impact
*
Economic Development
Social Benefit
Environmental Sustainability
Innovation
Education
Other
Estimated Number of Beneficiaries or Users
*
Upload Supporting Documents (e.g., project proposal, business plan)
Upload a File
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Choose a file
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List any relevant experience or previous licenses held
Submit Application
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